Bottom Line:
Falls were sustained by 28.4% of participants.In multivariable-adjusted analyses, participants classified as frail were over two times more likely to report falls [odds ratio (OR): 2.39, 95% confidence interval (CI): 1.22-4.71, P = 0.01], and participants with a CES-D score 18+ and/or prescribed antidepressants were over 80% more likely to be fallers (OR: 1.83, 95% CI: 1.23-2.74, P = 0.003) than were participants with a CES-D score <18 and no prescribed antidepressants.Frailty and depressed mood, factors that are potentially modifiable, are prominently associated with falls.

Affiliation: United States Renal Data System , Rehabilitation/Quality of Life Special Studies Center , Emory University , Atlanta, GA , USA.

ABSTRACT

Background: Falls among patients undergoing maintenance hemodialysis (HD) have significant consequences for quality of life and functional independence, morbidity, healthcare utilization and even mortality, but studies on the etiology of falls within large HD cohorts are limited.

Results: Falls were sustained by 28.4% of participants. In multivariable-adjusted analyses, participants classified as frail were over two times more likely to report falls [odds ratio (OR): 2.39, 95% confidence interval (CI): 1.22-4.71, P = 0.01], and participants with a CES-D score 18+ and/or prescribed antidepressants were over 80% more likely to be fallers (OR: 1.83, 95% CI: 1.23-2.74, P = 0.003) than were participants with a CES-D score <18 and no prescribed antidepressants.

Conclusions: Frailty and depressed mood, factors that are potentially modifiable, are prominently associated with falls.

SFU034F2: Percentage of participants who reported falls, by types of antidepressant medication prescription and no antidepressant medication prescription. Examples of participants' prescribed SSRIs include escitalopram, fluoxetine, sertraline and paroxetine. Examples of participants' prescribed atypical antidepressants include bupropion, mirtazapine, trazodone and venlafaxine. Examples of participants' prescribed tricyclic antidepressants include amitriptyline, doxepin and nortriptyline. Twenty-eight percent of patients for whom an SSRI was prescribed were also prescribed a medication in another antidepressant category.

Mentions:
Figure 1 shows the proportion of study participants who reported falls within the four CES-D score/antidepressant categories. Approximately one-third of participants had an elevated CES-D score and/or had antidepressant medications prescribed. Participants in this combined grouping, compared with participants in the reference category of non-elevated CES-D score and no prescribed antidepressants, were over 80% more likely to be fallers (OR: 1.83, 95% CI 1.23–2.74, P = 0.003). Figure 2 shows that the proportion of patients who experienced falls was similar across the three antidepressant categories (48% for those with SSRIs prescribed, 42% for those with atypical antidepressants prescribed and 43% for those with tricyclic antidepressants prescribed).Fig. 1.

SFU034F2: Percentage of participants who reported falls, by types of antidepressant medication prescription and no antidepressant medication prescription. Examples of participants' prescribed SSRIs include escitalopram, fluoxetine, sertraline and paroxetine. Examples of participants' prescribed atypical antidepressants include bupropion, mirtazapine, trazodone and venlafaxine. Examples of participants' prescribed tricyclic antidepressants include amitriptyline, doxepin and nortriptyline. Twenty-eight percent of patients for whom an SSRI was prescribed were also prescribed a medication in another antidepressant category.

Mentions:
Figure 1 shows the proportion of study participants who reported falls within the four CES-D score/antidepressant categories. Approximately one-third of participants had an elevated CES-D score and/or had antidepressant medications prescribed. Participants in this combined grouping, compared with participants in the reference category of non-elevated CES-D score and no prescribed antidepressants, were over 80% more likely to be fallers (OR: 1.83, 95% CI 1.23–2.74, P = 0.003). Figure 2 shows that the proportion of patients who experienced falls was similar across the three antidepressant categories (48% for those with SSRIs prescribed, 42% for those with atypical antidepressants prescribed and 43% for those with tricyclic antidepressants prescribed).Fig. 1.

Bottom Line:
Falls were sustained by 28.4% of participants.In multivariable-adjusted analyses, participants classified as frail were over two times more likely to report falls [odds ratio (OR): 2.39, 95% confidence interval (CI): 1.22-4.71, P = 0.01], and participants with a CES-D score 18+ and/or prescribed antidepressants were over 80% more likely to be fallers (OR: 1.83, 95% CI: 1.23-2.74, P = 0.003) than were participants with a CES-D score <18 and no prescribed antidepressants.Frailty and depressed mood, factors that are potentially modifiable, are prominently associated with falls.

Affiliation:
United States Renal Data System , Rehabilitation/Quality of Life Special Studies Center , Emory University , Atlanta, GA , USA.

ABSTRACT

Background: Falls among patients undergoing maintenance hemodialysis (HD) have significant consequences for quality of life and functional independence, morbidity, healthcare utilization and even mortality, but studies on the etiology of falls within large HD cohorts are limited.

Results: Falls were sustained by 28.4% of participants. In multivariable-adjusted analyses, participants classified as frail were over two times more likely to report falls [odds ratio (OR): 2.39, 95% confidence interval (CI): 1.22-4.71, P = 0.01], and participants with a CES-D score 18+ and/or prescribed antidepressants were over 80% more likely to be fallers (OR: 1.83, 95% CI: 1.23-2.74, P = 0.003) than were participants with a CES-D score <18 and no prescribed antidepressants.

Conclusions: Frailty and depressed mood, factors that are potentially modifiable, are prominently associated with falls.